Wednesday, September 17, 2008

Tsunami postscript: Rebuilding a nation after a disaster

The December 2004 tsunami generated an unprecedented challenge for the countries affected in terms of a staggering human death toll, displacement and destroyed infrastructure and assets.

In Sri Lanka, the tsunami affected around one million people and devastated over two thirds of the country’s coastline. In its aftermath, more than 1,500 children were orphaned; more than 35,000 lives were lost; while another 20,000 were injured. Common infrastructure and public utility supplies were severely affected, further hampering relief and rescue missions in remote coastal areas. The total cost of relief, rehabilitation and reconstruction efforts in Sri Lanka was estimated at around USD 2.2 billion.

Tsunami-affected areas were vulnerable to the spread of communicable diseases with the displacement of people, deterioration of sanitary conditions, lack of clean drinking water and shelter, disruption of health infrastructure resulting in a delayed and ad hoc distribution of medical aid. With this backdrop, the government was faced with an enormous challenge of addressing the immediate health needs of affected populations.

To control the spread of diseases among the displaced, essential supplies and medicines were distributed:
• mosquito nets
• emergency first aid kit
• malaria kits
• chlorine tablets
• testing and sanitation kits
• vitamins

Rebuilding a nation
After the initial relief stage, which focused on bringing immediate relief to the people, the government commenced the next stage: rebuilding a nation battered by tsunami.

Recovery and reconstruction activities were organized under four thematic areas: getting people back into their homes, restoring livelihoods, health and education-protection, and national infrastructure development. The government and development partners also worked on a number of cross-cutting themes such as environment, gender, legal aspects, and disaster preparedness.

A round-the-clock tsunami operation cells were established in each district, with teams and working groups tasked to oversee the distribution of medical donations and supplies. Together with its development partners, the Ministry of Health (MoH) identified medium and long term priorities to attend to:

• Restoration of services and reconstruction/renovation of health clinics and hospitals completely or partially damaged by the disaster
• Provision of essential medical supplies and drugs
• Mobility of medical teams and personnel
• Health protection and disease prevention of over 500,000 internally-displaced population (IDP)
• Addressing the mental and psychosocial needs of the affected communities
• Restoration and improving basic health and nutrition services and interventions
• Developing an early warning system and disaster management unit in the MoH

However, there were also a number of issues faced by the government and the development partners, for which possible solutions were found. Some of the issues were coordination of health activities at all levels soon after the disaster, developing, communicating and maintaining standards to all stakeholders, construction and rehabilitation of health facilities, addressing the human resource shortages, emergency preparedness system and plan, logistics and distribution, monitoring of IDPs’ health and quality of life and ensuring the sustainability of services.

Relief partners
The massive outpouring of assistance from civil society and the response of the international community with humanitarian aid including rescue teams, medical and food supplies, equipment and personnel was exemplary. This demonstration of human solidarity and kindness helped to curb any outbreak of disease among affected communities. The health practices and knowledge of the people also contributed to reduce health risks.

Responding to the crisis, partner-organizations of the People’s Health Movement (PHM) – Sri Lanka established centers to assist the displace. Sarvodaya, one Sri Lanka’s biggest charities and a member of the PHM, worked to sustain the displaced by providing cooked meals, clothing, and attending to their basic health needs. Special attention was paid to maternal and infant care. As it was necessary to maintain good health and hygiene practices amongst the displaced people information campaigns were conducted in the tsunami shelter sites. Awareness among the residents were raised by distributing leaflets and posters in the sites. Volunteers from Sarvodaya also visited these sites providing health education to the displaced.
On long term reconstruction and recovery efforts Sarvodaya constructed shelters, preschools and playgrounds. The beneficiaries also received household utensils and educational material.

Article by: Gireesha de Silva, Issue 12, Health Alert Asia Pacific
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Reference: Post Tsunami Recovery and Reconstruction, December 2006
Photo courtesy of Sarvodaya

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